Linkerharthelft

Linkerharthelft is a term used in German-language medical literature to describe strategies and devices designed to support the functioning of the left side of the heart in patients with severe heart failure. It encompasses both temporary, external support used in acute settings and implanted devices intended for longer-term use.

The most widely used form is the left ventricular assist device (LVAD). LVADs draw blood from the left ventricle and push it into the aorta, thereby reducing ventricular workload and maintaining systemic circulation. Devices may operate as pulsatile or continuous-flow pumps, with modern models favoring continuous-flow design for smaller size and durability.

Clinical indications typically include end-stage systolic heart failure, cardiogenic shock unresponsive to medical therapy, bridging to heart transplantation, or destination therapy for patients who are not transplant candidates. Selection requires multidisciplinary evaluation and careful assessment of comorbidities and anatomy.

Implantation involves surgery or percutaneous approaches, followed by lifelong follow-up. Patients generally require anticoagulation to prevent thromboembolism and must manage potential complications such as bleeding, infection at the driveline, device malfunction, stroke, and right heart failure after LVAD support.

History and status: early mechanical assist devices emerged in the 1960s and 1970s as experimental approaches. Modern LVADs (including pulsatile and mainly continuous-flow systems) have become standard options for selected patients, with several devices widely available and regulatory approvals in many countries. Ongoing research aims to reduce complications, enable fully implantable or wireless systems, and expand candidacy.